Abstract:
BACKGROUND/OBJECTIVES:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are medical emergencies. Mainstays of treatment include removal of the offending agent, supportive care, and wound care. The use of immunosuppressive agents such as corticosteroids and intravenous immunoglobulin (IVIg) is controversial. Some case reports and small studies report the successful use of cyclosporin A (CsA) for SJS/TEN in halting disease progression, fostering reepithelialization, and reducing mortality. OBJECTIVE:To report on the efficacy of cyclosporine A in the treatment of SJS/TEN in three pediatric patients. METHODS:We describe three pediatric patients seen at a tertiary care hospital in Boston, Massachusetts, diagnosed with SJS/TEN confirmed by skin biopsy who were successfully treated with CsA with improvements seen in time to cessation of disease progression or new lesion formation, reepithelialization, and duration of hospital stay. RESULTS:The average time cessation of disease progression or new lesion formation after CsA administration was 2.2 days (range 1.5-3 days) and average time to remission or reepithelialization was 13 days (range 10-15 days). The average length of hospital stay was 11.7 days (range 4-19 days). CONCLUSIONS:We describe three pediatric patients treated successfully with CsA and provide evidence for the use of cyclosporine in children with SJS/TEN. These results further support previous observations that CsA use for SJS/TEN produces consistently favorable outcomes. The results in this case series are limited by their observational nature. Additional trials are needed to evaluate the safety and efficacy of CsA use in children.
journal_name
Pediatr Dermatoljournal_title
Pediatric dermatologyauthors
St John J,Ratushny V,Liu KJ,Bach DQ,Badri O,Gracey LE,Ho AW,Raff AB,Sugai DY,Schalock P,Kroshinsky Ddoi
10.1111/pde.13236subject
Has Abstractpub_date
2017-09-01 00:00:00pages
540-546issue
5eissn
0736-8046issn
1525-1470journal_volume
34pub_type
杂志文章abstract::Corticosteroids and photochemotherapy, using a combination of psoralen and ultraviolet A (PUVA) exposure, are the most widely prescribed therapies for vitiligo. These treatments are not uniformly effective and many patients have inadequate responses. Calcipotriene has been shown to be effective in adults and children ...
journal_title:Pediatric dermatology
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journal_title:Pediatric dermatology
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journal_title:Pediatric dermatology
pub_type: 杂志文章
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journal_title:Pediatric dermatology
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